[blackdog]

It’s funny you should bring this up right now because I just went off my meds and I’ve been asking the same question.

I missed my meds one day and then decided to stay off them for a little while, so I could reevaluate things. I’ve been wondering for awhile if they are really doing any good at all. Today is day 3 and I have to say the answer seems to be no, they aren’t. Aside from being a little more depressed, which I expected, there hasn’t been much change.

I have also been questioning whether or not I really have ADHD, since the meds don’t seem to be making much difference. The answer, if I look at just the present, seems like no. But then, if I look back to my childhood, it becomes a resounding yes. (I’m thinking in particular about walking to school, sauntering along through the woods, watching the squirrels gather nuts, listening to the birds and calling back to them to see if I can get them to talk to me….. and all the other things I wrote in the letter the principal forced me to write about why I was always late.)

The problem, I have concluded, isn’t that I don’t have ADHD but that the meds aren’t working. I’m going to start titrating again, gradually, and try to keep track of how I am responding more than I did before. It may be I was taking too much and I’ll do better with a lower dose. Or it may be that I just need to quit my whining and get off my arse and do what needs to be done…

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[blackdog]

Do normals get cognitive fatigue? Yes, everyone does. In fact, “normals” probably get it more than someone like you shutterbug because they don’t have that ability to hyperfocus for hours or days at a time.

Myself, I get it after reading 2 or 3 comments on here, or one really long one. I literally fall asleep reading all the time. But then as soon as I stop reading and get up to go do something else, I feel fine. This happens all the time when I go to get ready for bed. I’ll be reading a book, or playing a game, or whatever, and I can’t keep my eyes open so I decide to go to bed. But by the time I have changed into my pjs, brushed my teeth (maybe, if I remember) and put away the leftovers from dinner that I forgot to put away earlier, I’m wide awake again.

Breaks work, as long as they are breaks. My problem is I never actually take a break. I can’t just sit down and rest or eat without reading a book or doing a crossword or watching TV or something. Then I just feel more tired and I don’t want to go back to whatever I was doing. Exercise, like a brisk walk, is okay because it doesn’t involve thinking, or at least uses a different part of the brain.

I know what you mean by not wanting to be interrupted by breaks and risk getting distracted and not getting back to work.  Happens to me every day. I would suggest just making sure you pause once in awhile and stand up and stretch, or jump up and down a few times, any kind of movement. (I will sometimes just shake my head and slap/rub my cheeks a few times, to help me “wake up”.) Or you could take a few seconds to close your eyes and breathe deeply and let your brain rest. Another one of my favourite techniques is rebooting, commonly referred to as “spacing out” by the “normal people”. Just sipping a cup of hot tea while staring off into space for a couple of minutes can do wonders. You might actually find it makes you more productive.

A blast of cold air can help too. Sometimes the smell or taste of citrus or mint is good…

And I am having trouble keeping my eyes open right now. Time to go nite nite.

 

 

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[blackdog]

Hi @1of347namesconsidered, welcome to TADD. (Love your user name. I might steal it next time I need to come up with one.)

I can relate to what you are talking about, in pretty much every part of your comment. I think I must be somewhere in between you and your brother. I am not overly hyperactive, or terribly brilliant, but I seem to annoy people when I talk about things the same way you do and I jump from one interest to the next like your brother does without ever finishing anything. But then I end up getting frustrated and give up and sit on the couch like a lump for a day, or 2, or 365.

I love showing how smart I am, and I get very distressed when people don’t listen or give me the attention I feel I deserve. Like the time when my parents kept telling everyone that one of their friends who helped us move figured out how to make the fridge fit in the kitchen by raising the ceiling, when it was actually my idea. The friend suggested it to them because he was the only one who was listening to me when I suggested it. And I corrected them every time and it was like I wasn’t even speaking….. And this was when I was a teenager and I still haven’t let it go.

I became aware that I use intellectual arrogance as emotional armour… probably a few years ago, not sure but that’s what it feels like (which is how I place things in time, by “feeling”). I am a failure in every aspect of my life and I have to prove how smart I am and how capable I am constantly in order to compensate for it, which leads in turn to more failure when I get myself into trouble by shooting my mouth off or taking on a task just to prove I can and then having it turn out I can’t. I keep trying to give up completely and just resign myself to a life of mediocrity, but I fail at that every time too.

I also have an extremely low tolerance for willful ignorance (aka stupidity) and sometimes just can’t stop myself from correcting people who I feel are exhibiting such ignorance. Which makes me seem like, as one person put it, an “intellectual snob”. I don’t really mean to be and I try to be patient, especially with those who have a legitimate reason for not being “smart”, but I just lose my patience at times and I can’t stand it anymore.

On the other hand, it can be quite embarrassing when I think I know more than I do and it turns out I’m the one who is wrong. Not that I ever admit to being wrong. I just keep on talking until I manage to make it sound like I’m right, or at least like it’s not my fault that I’m wrong, or I just wear the other person down. As a last resort, I might admit to being misinformed and say that I will look into the subject further.

Anyway…

I know exactly what you mean when you say that people misinterpret your answers and take everything the wrong way. And about trying to connect with people by discussing shared interests and having them end up being put off. It’s sometimes because they think I’m being a show off I guess. Sometimes it’s the opposite, because I don’t seem to know enough about the subject to suit them. I like to discuss things like comics,  movies, The Big Bang Theory, and the Big Bang, because I am interested, but because  I don’t know *everything* there is to know, people sort of dismiss me and don’t want to talk to me about it. Or they correct me and start lecturing me when I get one teeny little thing wrong. At least that’s the way it seems to me, but then that might just be my insecurity.

I don’t know what the solution is, if there is one. I have just accepted that on the rare occasion that I do make a friend, it won’t last long. Even with people I seem to be really compatible with, they will eventually just stop talking to me. Fortunately, I’m pretty good at entertaining myself and don’t really feel the need to be around people much. (emotional suit of armour #2)

 

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[blackdog]

Ah ha! Thanks for bringing this thread up @deebee. I knew I’d seen something, somewhere… but that’s about all I ever know.

Okay, I think I do understand this now. The doctor probably went “off label”, prescribing more than the recommended maximum dose of Dex, or wrote the prescriptions too close together, or something. But I think he was overreacting when he refused to prescribe the Dex, or any other med. Unless this is not an isolated case and he has reason to be afraid of getting into trouble.

I just started on 10 mg of Dex, in addition to 80 mg of Vyvanse and 300 mg of Welbutrin. The pharmascist reacted predictably, giving me all kinds of unnecessary warnings and prattling on about how I am already taking “a very high dose of Vyvanse”. 🙄 But other than that, I have had no issues with getting my meds. So there is something fishy about this.

Vyvanse is schedule II and subject to all the same restrictions as the others, despite being theoretically abuse proof. In addition to that, the maximum dose was set ridiculously low by the FDA, so it might might not be helpfull to try switching to it in a case like this.

 

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[blackdog]

Okay, I just looked up the NMS.

I looked at the “patient brochure”, which no one ever showed me and basically just uses a lot of words to say “take ID with you when you go to the pharmacy”.

The FAQ section is pretty much equally redundant. One answer I got from it though is that the pharmacists do have the ability to use their own judgement when they receive a DUR, as the manager did for me that one time when I was  too early.

So, knowing how the system works, it is possible that the pharmacy might refuse to fill a prescription if they get a DUR that the patient has been using multiple pharmacies.

But it still doesn’t explain this letter thing. I see no way that the College of Physiscians and Surgeons could send out a letter specifically targeting one patient. They shouldn’t have access to the information to begin with. According to what I read, even your own doctor can not access the data collected through the NMS. And they are not responsible for monitoring patient care or anything that I know of.

I don’t know, but the whole thing is part of the ehealth system, which has been messed up from the start, so no surprise if it is causing problems.

I wasn’t able to read the Narcotics Safety and Awareness Act because I’m on an iPad  and it doesn’t seem to be accessible on mobile. Perhaps there is something there that would explain it.

Here’s the link to the info on the Narcotics Monitoring System:

http://www.health.gov.on.ca/en/public/programs/drugs/ons/

 

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[blackdog]

Well, my doctor has known me for…. Yikes! It’s been 28 years. Geez, I’m getting old. Anyway, medical records pretty much take care of both the ID and the diagnosis, so I don’t really understand that part. Unless it applies to those who don’t have a regular doctor and have to rely on the walk in clinics. The clinics don’t prescribe narcotics as a general rule, but if you don’t have a doctor they sort of create a file for you, if you always go to the same one, so I guess they might make an exception.

The pharmacy has known me just as long as the doctor, though I think there is only one of the original employees from way back then left. Most of them do ask for my ID, just as a formality, but when they are really busy or they know I’m in a hurry they just grab my pills for me.

If they start cutting people off because they forget to get their prescriptions filled, I’m gonna be screwed. Though I think my doctor is beginning to understand that forgetting my meds doesn’t mean I don’t need them.

It’s not so easy to have multiple doctors to get multiple prescriptions anymore, since doctors are in such short supply. But I guess some people still do it somehow.

As for getting health care in Ontario, it depends on your situation I guess.

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[blackdog]

@fishjacks

You have probably got this sorted by now, but I’ll weigh in anyway.

First, as always, I have to say everyone is different, so it’s not possible for any of us to say what is right or normal for you.

That being said, it sounds like you may be very sensitive to stimulant drugs, as some people are, and you may need a lower dose, like shutterbug. Another possibility is that Adderall is just not the right medication for you. You may possibly do better on a methylphenidate med, like Ritalin. Some people react better to one than the other. Or you may do better with a slow release medication, such as Vyvanse, although typically hyperactive types do better with the fast acting meds (based on comments I have read here in the forums).

You also need to give it a little longer to know if it’s really going to work or not. 2 or 3 days isn’t enough. It will take at least 2-3 weeks on any medication to know how it is really going to affect you.

When you have ADHD, a stimulant medication should make you feel calmer, not speed you up, like it would for other people. We are wired differently so things affect us differently. That is a good indication that your diagnosis is probably right. But if it is making it hard for you to function, or giving you really bad side effects that don’t go away, then it is not doing what it should.

Some doctors don’t  have a lot of experience with stimulants or ADHD, and they tend to think inside the box and don’t consider all the possibilities. And they sometimes make mistakes in prescribing dosages that are too high, or increasing the dosage too quickly, because they are just going off of what they know and are used to doing. So make sure you read up on the medications yourself and you  can make informed choices.

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[blackdog]

@deebee

You can say that again! I nearly faint every time I get my perscription filled. And it gets more expensive as you increase the dosage.

It took awhile for my doctor and pharmacy to work out the prescription problem. They weren’t happy with the way that he was writing them at first, I think because it wasn’t clear that I could only get 30 at a time. And then he told me to increase my dosage, but didn’t provide me with a new script, which I didn’t notice at the time, and I had to call the office and try to explain to them that he had to fax a new script to the pharmacy before I ran out. Then he messed it up completely when he increased it to 80 mg but only gave me a script for 20 mg, assuming that they would just fill that and the previous one for 60 mg….

So in short, it really depends on the doctor, and how much experience they have. And yeah, there are probably a few here in Canada who try to do the monthly appointment thing to make extra money too. The difference is, they can get caught here, if they have enough unnecessary appointments for it to become suspicious. My doctor usually schedules an appointment every 3 months, because I am still struggling to figure out what works for me. If I get to the point where I am more stable and the meds seem to be helping, then he’ll drop it to twice a year probably (going by past experience).

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[blackdog]

@tatltael I dont have the time to read the other responses (either that or I’m just too lazy to), so excuse me if I repeat what has already been said.If it is ADD, you should be able to see symptoms of it going back to when you were little. Did you daydream a lot then? Take more time to do things than other children? Have trouble listening and paying attention? etc.If you didn’t notice any symptoms until now, it’s still possible that it is ADD and you are just seeing it now because you have more responsibility, harder work to do at school, more stress etc. But it also could be some other problem, something that has changed with your health. So you really should see your doctor and talk to your parents. Just tell them that you are not feeling well and you think something might be wrong. You don’t have to say that you think it is ADD.It also could just be that you are adjusting to be a teenager. It’s very common for teenagers to have problems like this, especially if they are not sleeping enough. You need to sleep.One thing for sure is that it is not “just laziness”. If you were just lazy, you probably wouldn’t care enough to ask the question. The fact that you are worried about not being able to do your school work shows that you are having a real problem, because you want to do it and you still can’t. So don’t be afraid to ask for help. Whether it’s ADD or just the normal stress of high school life, you need to get to the bottom of it and get it straightened out so that you can be successful and have the kind of life you want to have.

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[blackdog]

@deebee

I don’t really know much about the regulations myself, aside from the fact that if I go to get my prescription filled even a day or two early they tell me they can’t do it, which is really annoying. Although the head pharmacist seems to have the ability to override that because there was one time when the girl told me no she heard and called out “it’s okay” and then filled it for me.

The pharmacy I use just started requiring ID for narcotics about… no, exactly… 3.5 years ago. I remember because I was picking up meds for my dad and they asked for ID and I was confused because they never did before.

I meant to ask my doctor about this letter thing, because I don’t understand it, but I forgot. But it depends a lot on the individual doctors, their knowledge of the medications, and ADHD, and any preconceptions they might have.

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[blackdog]

Hi @pinkdex

This is one of the biggest difficulties with these types of medications.

Its impossible to give any really specific advice about medications because everyone is different and there is no way to know how one person will react or what will work best. And I have very little experience with methylphenidate so I don’t know what a typical dosage is.

First, I would recommend making sure that it is the medication that is the problem. There could be something else affecting you that is making it seem like the meds aren’t working anymore.

Secondly, I would suggest discussing your concerns and your options with your doctor. One possibility is to switch medications instead of increasing the dose. If you are building up a resistance to the methylphenidate then maybe starting fresh with something new, like an amphetamtemine based med, might allow you to control your symptoms and stay on a lower dosage. Another possibility is adding a “booster”, a small dose of a short acting med just to give you a little extra boost when you need it.

These are just examples of what is possible based on my own experience and research. What will work for you is up to you and your doctor to decide. You may want to talk to your pharmacist too and see what they think, since they (usually) understand the medications a little better.

 

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[blackdog]

@clayhughes

Actually, 50 mg of Vyvanse is not that big. Because of the way it’s formulated, the dosages work differently. For example, I take 80 mg of Vyvanse, which is equivalent to 35 mg of Adderall. And some people take two 30 mg doses of Adderall a day- and that is BIG!

However, my eyeballs did pop out when I read the original post here and I was in a panic to respond, until I noticed the date. Too late now for that person, but for future reference, amphetamine and methylphenidate do not mix! I am shocked and outraged that a psychiatrist would even recommend taking both, and that he would recommend just taking the Vyvanse off and on, when you want to concentrate for longer periods. Extremely bad. I mean, that’s the kind of “ADHD behaviour” that we get told off for all the time,  playing with our meds and only taking them when we feel like it.

Anyway… I dont know if alcohol actually makes ADHD worse. I never did drink that much, and hardly at all now. It is best to limit alcohol when taking meds, as any pharmacist will tell you, but it is still possible to enjoy a couple of drinks once in awhile. Like the psychiatrist who first prescribed medication for me said: “You can drink, just don’t get drunk”.

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[blackdog]

It’s not just the manipulation of facts to make it more sensational or entertaining, it’s the deliberate misdirection, distraction and manipulation of public opinion.

They distract us with fluff about the latest fashion trends and the size of Kim Kardashian’s buttocks so we won’t focus on the serious issues, like poverty and human rights.

They misdirect us with sensational stories about car accidents and house fires which, when you really think about it, are completely irrelevant except to those directly involved. It can be helpful to have these reports at times, when a family is really having a hard time and need some help for example, but for the most part, we really don’t need to know.

And they manipulate public opinion by focusing on certain stories, or not focusing on them, use of certain phrases, even by the way they combine stories.

Like, for example, the “Ground Zero Mosque” back awhile ago, which was actually a building several blocks away from the “ground zero” site where an ordinary Imam wanted to start an ordinary Mosque for ordinary Muslims. But by labelling it the “Ground Zero Mosque”, and following every single report on it with one about a completely unrelated violent act somewhere else in the world, they manipulated the public into associating something that posed no threat to anyone, that is so commonplace they would normally not even notice it, with terrorism and war. And I watched them do this on 5 different news casts on 3 different networks.

This  example sticks in my mind because it happened not too long after I watched Russel Peters “Black, White and Brown” on TV. I’m not really a fan, but I remembered his bit about the media, and specifically the reference to how they show you a picture of a Muslim, then show you a bomb going off.

“Hmmm, what do you think?”

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[blackdog]

Oh, to answer your question about how much to ask the doctor to go up, I would say 10 mg a week. Some doctors will increase by 20 mg at a time, sometimes with only a couple of days between, but from what I have read, and my personal experience, it’s better not to go up that fast. It’s something only you and your doctor can decide though.

And again, it is a controlled substance. Your doctor may be reluctant to increase your dosage, and even more so if you ask to double it. A sudden increase of 40 mg would look suspicious and could actually get him/her in trouble.

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[blackdog]

@4moecon

Welcome to the site.

Medication advice is difficult to give because everyone is different. There is no way to tell how you will react to one medication or dosage because you are a unique individual.

But I can tell you that suddenly doubling your dose is a very bad idea, especially without consulting your doctor first. Personally, I would not double my Vyvanse  even if my doctor told me to. It’s stronger than it appears to be and its easy to overshoot and end up taking too much, which might actually be what happened to you. Sometimes when it seems like a medication isn’t working as well as it should it’s because you need less, not more. It could also be hazardous to your health, as it can increase your blood pressure and heart rate, or cause other side effects.

It sounds like you were thinking if you double your dose you will have double the energy and concentration. Unfortunately, it doesn’t work that way, especially when you ADHD. Your brain is wired differently and responds differently to stimulants. Simply put, overdoing it is more likely to put you to sleep than keep you going.

I can’t comment on the confidentiality issue because I don’t work for Totally ADD. But keep in mind that Vyvanse is a controlled substance, so if you run out before it’s time to refill, you’re out of luck, at least as far as getting it from your pharmacy goes. You should also keep in mind that it is a very toxic substance that is really not too good for your health at high doses over time. What you want to look for is your “therapeutic window”, the minimum dose needed to give you the benefits of the medication without any harmful affects.

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